Review: The Checklist Manifesto: How to Get Things Right

The Checklist Manifesto: How to Get Things Right by Atul Gawande
My rating: 5 of 5 stars

This book was thoughtfully suggested to me by the pattern-seeking gremlins who live in my computer and who seem to know me better than I know myself. Uhhh…read a book about checklists? Could anything be more banal? Although apprehensive, I decided to trust the algorithmic gremlins.

I bought it. I read it. I loved it.

The author, Atul Gawande, is a surgeon and a writer. He got hooked on the idea of improving outcomes for patients by getting the professionals in the operating theater to use checklists. He starts out with some harrowing tales of failures and near-failures caused by simple human error – the kind of human error that many of us think is unavoidable – the kind of human error we don’t like but we seem to accept.

Gawande does not seek perfection. However, he is deeply committed to eliminating as much ineptitude as possible by getting decision makers to submit themselves to the most pedestrian of life’s tasks – using a checklist. He is particularly focused on life/death situations, where the most trivial slipup will kill one or many people. Using examples from hospital operating rooms, pilot cabins of commercial airplanes, and skyscraper construction sites, Gawande shows how taking less than a minute to consult a thorough “read-then-do” checklist saves lives and also many millions of dollars.

Creating good checklists and using them does not require a professional to learn a new skill. There are no special classes or certifications to chase down and no hard effort to add to an already hard job. Nothing is required at all, except a very brief subjugation of self .… to the list. All that is needed is an admission that our complicated, busy and important tasks can be reduced to a checklist, and errors, especially errors which take lives, can be minimized.

It is a tough sell, apparently. People want improvement and solutions, he learned, but prefer them to be more convoluted or complex. Getting people to use checklists, as easy as it sounds, is anything but. Yet, he persists and with extraordinary outcomes. In his multi-hospital study, where a 9 item checklist was used in the operating rooms, post-surgical complications were reduced by 36%....without spending one dollar.

Technology continues to add speed and distance between us and the things we do and produce. As this trend continues, taking 30 human seconds to look at a list sounds like a very good idea to me.


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